The Benefits Selections section allows you to select your health, dental, and/or vision coverage as well as other selections. You can also waive any type of coverage or all coverage. Pharmacy coverage is included in the health coverage.

Waiving all 3 Coverage for Yourself - Health, and Dental, and Vision

If you are waiving Health, and Dental, and Vision coverage for yourself, you cannot enroll any dependents for coverage.

Step 1 - Populate the following:

Health Coverage - Click the drop-down list, select DO NOT WANT, and then click OK to confirm acknowledgement of waiver.

Dental Coverage - Click the drop-down list and select DO NOT WANT.

Vision Coverage - Click the drop-down list and select DO NOT WANT.

Are you covered by other Health Insurance? - Click the drop-down list and select Yes or No.

Did you receive the ABC Booklet? - Click the drop-down list and select Yes or No.

Prepaid Legal Plan? - Click the drop-down list and select Yes or No. Click the Details on U.S. Legal Services link for more information on the prepaid legal plan.

Health Coverage - Click the drop-down list and select the desired plan, or select DO NOT WANT and click OK to waive health coverage.

DO NOT WANT - If you selected DO NOT WANT to waive health coverage, proceed to Step 2-Dental Coverage, otherwise, proceed to Step 1.2 below to continue with your Health coverage selections.

HUMANA-CDH HIGH, HUMANA-CDH LOW, HUMANA-HDHP, or HUMANA-OUT OF NET - If you select any of these options, the 2014 Tobacco Affidavit window appears. The affidavit asks whether you, or any of your dependents (age 18+) insured under the County health program currently use, or have used, tobacco products within the last one hundred twenty (120) days.

If you answer ‘Yes’ in the Affidavit, effective with the 1st paycheck on January 11, 2014, a $20 bi-weekly Tobacco Surcharge will apply and will be shown on your pay stub as TOBACCO SURCHG.

If you answer ‘No’ in the Affidavit, it then becomes the employee’s responsibility to notify the County’s Benefits Office within 31 days if you, or any insured dependents (age 18+), resume and/or begin using tobacco products. As a result, a $20 bi-weekly Tobacco Surcharge will be added to the employee's payroll deductions. This affidavit does not roll over year to year and the employee will be required to submit a new affidavit each year as part of the County’s annual Open Enrollment.

Click the appropriate check box in the 2014 Tobacco Affidavit window and then click OK.

If you select DO NOT WANT to waive dental coverage, proceed to Step 3-Vision Coverage to select your Vision coverage, otherwise, proceed to Step 2.2 below to continue with your Dental coverage selection.

If you select COMPBEN-DHMO, the Facility # field, the Dentist List link, and the CompBenefits link will appear.

Click the Dentist List link to view the list of dental providers (2014 COMPBEN DHMO PROVIDERS). Use this list to find a dentist of your choice and then write down the PCD Facility # of the desired dentist. You will need this number below. For more information on the CompBenefits plan, click the CompBenefits link to access the Humana CompBenefits webpage.

Once you’ve clicked on the Dentist List link, you will use this list to find a dentist of your choice. Each dentist has a PCD #. Type the PCD # in the DHMO Facility # field.

Note: The default PCD # is 000000. If you do not wish to select a dentist at this time, simply type 000000 and a dental provider will be assigned to you by the dental insurance. You can always select a dentist at a later time.